BHRS Certification - Exam
The examination was first introduced in 1999 as part of the BPEG Certificate of Competency. In 2006 the examination became the Heart Rhythm UK Certificate of Accreditation and structure of the examination was revised, with the introduction of core and specialist sections.
In 2011, the examination paper was marked electronically for the first time. Since then, the questions and candidates responses have been evaluated in detail so that we can continue to improve the quality, relevance and validity of the questions.
In 2013, the number of questions was increased to 120 (60 core and 60 specialty), in part, to bring the examination into line with the EHRA examination. As a consequence, the duration of the examination was increased to 4 hours. Also in 2013, we introduced a third “clinical” specialist section. This section is aimed at nurses with a special interest in CRM and is complimented by a new “logbook equivalent” of case discussions. It was not felt appropriate that nurses with a special interest in CRM complete a logbook, instead there is a requirement to complete a number of case studies.
|Exam overview presentation: “BHRS certification: An overview”|
|Exam Question Breakdown 2017 for each paper|
|Exam Terms & Conditions sheet|
|Exam answer sheet/marking sheet guidance|
|Updated syllabus and recommended reading list|
|Sample exam questions|
|Link to HRC (Heart Rhythm Congress) course talks|
|If you still have a query, please contact us at firstname.lastname@example.org for all exam / logbook queries|
PLEASE BE AWARE THAT FROM 2019 THE BHRS WRITTEN EXAMINATION WILL BE HELD AS PART OF HEART RHYTHM CONGRESS. THE EXAM WILL BE HELD ON THE SUNDAY AFTERNOON OF HEART RHYTHM CONGRESS IN BIRMINGHAM AND THIS WILL BE THE ONLY VENUE HOSTING THE EXAMINATION.
Certification Exam Pass Marks
Please note, pass marks vary slightly from examination to examination to take account of the relative difficulty of examinations presented to candidates, ensuring that the pass standard remains constant.
The pass mark is determined by a 'standard setting' process.
For example, in 2016, 136 candidates sat the Core section with the vast majority passing. The median mark is shown below for each section of the 2016 exam. Please note the median mark IS NOT the pass mark.
Core 57% n=136
Devices 57% n=133
EP 58% n=10
Clinical 55% n=5
All candidates who reach the required standard for the appropriate exam will pass, however it has been and continues to be the decision / policy of the BHRS Council not to disclose the actual pass mark or to enter discussions with individual candidates about their marks / examination performance.
Further details about the BHRS exam can be found in the below presentation available to download
Exam Question Breakdown 2017
Section 1: Core
|Core||Sub-Sections||Number of Questions|
|1.2||Arrhythmias - Diagnosis/ECGs||10|
|1.3||Devices (Inc. clinical trials)||15|
|1.4||Electrophysiology (Inc. clinical trials)||15|
Section 2: Devices
|Devices||Sub-Sections||Number of Questions|
|2.1||Pacemaker biophysics & physiology||7|
|2.2||Device indications & modes||10|
|2.3||Pacemaker follow-up, troubleshooting, CXR||15|
|2.4||Cardiac Resynchronisation Therapy||10|
|2.5||Implantable Cardioverter Defibrillators||10|
Section 3: Electrophysiology
|EP||Sub-Sections||Number of Questions|
|3.1||Basic EP (genetics, channels, drugs, clinical)||10|
|3.2||General concepts: Catheter position, access, signals, filter-setting. Intervals, block/gap, Arrhythmia mechanism - Pacing manoeuvres||10|
|3.3||Invasive electrophysiology - standard atrial arrhythmias (SVT, typical flutter)||15|
|3.4||Invasive electrophysiology - complex atrial arrhythmias (AF, atypical flutter, atrial tachycardia)||10|
|3.5||Invasive electrophysiology - complex ventricular arrhythmias (scar related, non-scar related, PVCs)||10|
|3.6||Invasive electrophysiology - Specific ablation aspects: lesion formation, energy sources. Complications & Imaging mapping systems||5|
Section 4: Nursing/Clinical
|Nursing||Sub-Sections||Number of Questions|
|4.2||Arrhythmias - Diagnosis/Mechaniss/ECG||15|
|4.4||Syncope diagnosis and treatment||5|
Exam Syllabus and Reading List
Sample Exam Questions
For any potential candidate considering taking the exam in the future, you may find it useful to view the below representative questions for the devices and EP sections:
- View Sample Devices Questions
View Sample Devices Answers
- View Sample EP Questions
View Sample EP Answers
- View Sample Clinical Questions
- View Sample Clinical Answers
Exam Answer Sheet Guidance
Since 2011, the examination papers have been marked electronically. This allows British Heart Rhythm Society to be able to examine the questions and candidates responses in more detail, so that we can work to improve the quality and validity of the questions. It is therefore essential that candidates are aware of how they are required to mark their answers on the exam answer sheets. Please click here to download the guidance.